The LAM Foundation 2012 Lymphangioleiomyomatosis International Research Conference will focus on the molecular mechanisms of smooth muscle proliferation and cystic lung destruction that occur in the fatal lung disease of women, Lymphangioleiomyomatosis (LAM). This is the thirteenth annual Cincinnati LAM conference, which has evolved from a dedicated family/patient conference to a state of the art scientific meeting for LAM and tuberous sclerosis. The basic science sessions will highlight research on the cellular and genetic basis of smooth muscle proliferation in LAM, and will focus on the role of exogenous growth factors, sex hormones, genetic mutations, lymphangiogenesis, intracellular signaling mechanisms and changes in transcriptional regulation. Additional sessions will explore the link between smooth muscle infiltration of the lungs and the cystic remodeling of pulmonary parenchyma, including the elaboration of metalloproteinases and connective tissue matrix by LAM cells. Concurrent clinical sessions will address difficult management issues in LAM, including hormonal therapy, air travel, pregnancy, lung transplantation and pleural complications. The Basic and Clinical Science tracks have been coordinated to allow all participants to attend keynote sessions and to traffic freely between sessions. A patient-oriented seminar will address key clinical issues for 175 LAM patients and LAM family members who are expected to attend, and will culminate in a summary of scientific sessions by the Basic and Clinical Track Chairs. A scientific roundtable discussion is held on the last day of the conference to review the key outcomes of the conference and to plan future conferences. Each session will be chaired by an expert in the field and will have invited speakers as well as speakers chosen from the pool of submitted abstracts. There has been a conscious effort to attract established investigators from related disciplines who can complement the expertise of the current pool of LAM investigators. Discussion facilitated by a discussion leader will be an important component of all sessions. Outstanding junior investigators will be awarded travel grants and will be given the opportunity to present their research in platform and poster formats. The goal of this conference is to provide a forum for leading experts to discuss the molecular and cellular basis of LAM, review the clinical management of LAM, to present cutting edge research, to integrate concepts and to identify creative and innovative research directions.